Quality Form / Document #
Revision: / QAF-172
E
TITLE: ITEM PART CLASSIFICATION FORM / Rev. Date: / 07/02/2015

EXPORT CONTROL CLASSIFICATION

In order to comply with applicableexport control regulations, KLX Aerospace Solutions is required to obtain detailed informationabout your company’s products.To enable KLX to order or supply your products, this worksheet is required for each part numberthatyour company supplies to KLX. For multiple line items, please utilize the Item Part Classification Spreadsheet (attached when needed).

PRODUCT

Manufacturer/Design Holder Name: / Your Company’s (Supplier) Name (if different):
Supplier/Manufacturer/Design Holder Part No: / Product Description:
Country of Origin: / Product Material:
Harmonized Tariff Schedule Code: / Country that the Harmonized Tariff Schedule applies to:
INTERNAL USE – EXCEL FILE NAME: / INTERNAL USE – CLASSIFICATION JUSTIFICATION:

EXPORT JURISDICTION AND CLASSIFICATION

Please answer Question 1 (US Export Jurisdiction), Question 2 (EU Export Jurisdiction) and/or Question 3 (Non-US, Non-EU Export Jurisdiction), as applicable. Then answer Questions 4 (Original Purpose) and 5 (Classification Justification).
1 - Is the product subject to U.S. export control regulations, as follows? If yes, please complete this section.
International Traffic in Arms Regulations (ITAR) YES: NO:
If yes, a U.S. Munitions List (USML) Category must be specified:
Export Administration Regulations YES: NO:
If yes, an Export Control Classification Number (ECCN) must be specified:
(If no specific ECCN is applicable, EAR 99 may be appropriate classification)
2 - Is the product subject to EU Export Control Regulations (including an EU country’s Export Control Regulation), as follows? If yes, please complete this section.
Military List (EU Common Military List, UK Military List, German Military List, other EU countries’ military list, etc.)
YES: NO:
If yes, a ML control entry number must be specified:
If yes, also identify applicable National regulation:
Dual-Use Controls (EU DU) YES: NO:
If yes, a EU DU control entry number must be specified:
If yes, also identify applicable National regulation:
Part is not subject to any Military List (EU Common Military List,
UK Military List, German Military List, other EU countries’ military
list, etc.) or the Dual-Use Controls (EU DU)? YES:
3 - Is the product subject to any other, non-U.S., non-EU export control regulations, as follows?
If yes, please complete this section.
Please identify applicable National regulation(s):
Was your Item/Commodity initially developed for a Civil, Dual-use OR Military application (select one)?
Dual-use item? YES: NO: If yes, indicate Control List-No. (if applicable):
Military Equipment/Use? YES: NO: If yes, indicate Control List-No. (if applicable):
Civil item? YES: NO: If yes, indicate Control List-No. (if applicable):
4 – Original Purpose: Please specify what the product was originally designed for (i.e. aircraft or platform)?
5 - Classification Justification: Your response to Questions 1, 2 and/or 3 is based on:
a commodity jurisdiction or commodity classification determination (provide date and determination letter and, if applicable, CCATS (or other government identification number)
self-classification by your company
information provided by the manufacturer or design holder
CERTIFICATION
Company Name: / Address/Phone Number:
With regard to the Product(s) above we are the: / Manufacturer
Supplier
Design Holder

I represent and warrant that the information provided herein is accurate and complete. I understand that I am liable for any false statements or material omissions made or in connection with this document. I shall immediately notify KLX AerospaceSolutions of any change in the information contained herein.

Printed Name: Title:

Telephone Number: Date:

Signature: ______

Email completed worksheets to KLX at: .

Worksheet Instructions
  1. To complete the 1st section titled “Product” please provide:
  • Manufacturer/Design Holder Name
  • Your Company’s Name (if different from Manufacturer/Design Holder Name)
  • Supplier/Manufacturer/Design Holder Part Number
  • A detaileddescription of the product.
  • The Country of Origin.
  • Product Material
  • Harmonized Tariff Schedule Code.
  • Country that the Harmonized Tariff Schedule Code applies to.
  1. To complete the 2nd section titled “Export Jurisdiction and Classification”:Please answer Question 1 (US Export Jurisdiction), Question 2 (EU Export Jurisdiction) and/or Question 3 (Non-US, Non-EU Export Jurisdiction), as applicable. Then answer Question 4 (Original Purpose) and Question 5 (Classification Justification).
  • Question 1: First, if theproduct is subject to U.S. export control regulations (either ITAR or EAR) please answer question (1) for U.S. Export Jurisdiction.
  • Please note that the United States export control lists (both ITAR and EAR) have undergone significant revisions since October 2013. Jurisdiction and classification determinations made prior to that time may have been affected by these revisions.
  • In general terms, items with substantial military or intelligence capabilities are controlled by the ITAR, while certain less-significant military items and civilian items are controlled by the EAR.
  • Your Product may have been classified pursuant to a formal determination by the Department of State, Directorate of Defense Trade Controls ("DDTC") or the Department of Commerce, Bureau of Industry and Security ("BIS"). If so, please provide this information.
  • Alternatively, a Product may be self-classified by the manufacturer or design holder. If self-classifying the Product, you must review the ITAR and the EAR to determine whether and how the Product is controlled under either set of regulations.
  • The government has provided online tools to aid this process, although neither is intended as a replacement for reviewing the applicable control lists.
  • The following tool from the DDTCcan help you determine whether your Product is subject to the ITAR:
  • If, after review, your Product is not subject to the ITAR, you must determine whether it is subject to the EAR and, if so, how it is classified. The following tool from BIS can help you determine the classification of your Product if it is subject to the EAR.
  • Check either the YES or NO box to indicate whether the product or any of its components are subject to the ITAR.

a)If yes, please provide the USML Category.

  1. Check either the YES or NO box to indicate whether the product or any of its components are subject to the EAR.

a)If yes, please provide the ECCN. (If no specific EECN applies, EAR 99 may be appropriate classification.)

  • Question 2: Second, if theproduct is subject to any EU Export Control Regulations (including any EU country’s Export Control Regulation) please answer question (2) for EU Export Jurisdiction.
  • Check either the YES or NO box to indicate whether the product, or any of its components,arecontrolled on a Military List (EU Common Military List, UK Military List, German Military List, other EU countries’ military list, etc.).

a)If yes, please provide the ML control entry number.

b)If yes, please also provide the applicable National regulation.

  1. Check either the YES or NO box to indicate whether the product or any of its components are controlled on the EU Dual-Use Controls list (EU DU).

a)If yes, please provide the EU DU control entry number.

b)If yes, please also provide the applicable National regulation.

  1. Check YES if the part is not subject to any Military List (EU Common Military List, UK Military List, German Military List, other EU countries’ military list, etc.) or the Dual-Use Controls (EU DU)?
  • Question 3: Third, if theproduct is subject to any other, non-U.S., non-EU export control regulations please answer question (3) for non-U.S., non-EU export control regulations.
  • Check either the YES or NO box to indicate whether the product or any of its components are subject to other, Non-US, Non-EU Export Control Regulations.

a)Identify applicable export control regime.

b)If Dual-use item, please provide Control List-No. (if applicable)

c)If Civil use item, please provide Control List-No. (if applicable)

d)If Military Equipment, please provide Control List-No. (if applicable)

  • Question 4:Please specify what the product originally was designed for?
  • Question 5: Please specify the source of information for your response to Questions 1, 2 and/or 3 (i.e., please specify what your classification/rating is based on).
  1. To complete the 3rd section titled “Certification” please provide:
  • Your company’s legal name and address.
  • Identify if your company is the manufacturer, design holder and/or supplier of the product.
  • The Authorized individual completing the form should:
  • Sign, print their name and title.
  • Include a telephone number.
  • Date the form.
  1. Email completed worksheets to